Provider Demographics
NPI:1720407984
Name:ASAH, EUNICE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:ASAH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 AUTUMNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8645
Mailing Address - Country:US
Mailing Address - Phone:972-393-0909
Mailing Address - Fax:817-635-8446
Practice Address - Street 1:2233 AVENUE J STE 103
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-5884
Practice Address - Country:US
Practice Address - Phone:972-393-0909
Practice Address - Fax:817-365-8446
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily